The biocultural profile of a population at risk in the U.S.-Mexico border.

Abstract

Non-insulin diabetes mellitus (NIDDM) is a major health problem affecting U.S. Mexicans. A population of Southwestern Arizona, near the U.S.-Mexico border, was studied to assess the biocultural environment in which disease develops, and to determine risk factors affecting the population. This geographic area is home to a high percentage of farmworkers of Mexican origin or ancestry. A global overview of macro- and micro-level issues was used to provide the context in which the population lives, and where the disease emerges and is maintained. The discussion of historical, economic, demographic, and social issues provide the background for the understanding of the natural and the social environments. Anthropological methods and techniques were used to assess and analyze numerous factors to determine the most useful for the identification of NIDDM risk. Methods used for data gathering included anthropometric measurements, survey instruments, ethnographic interviews, life history, and participant observation. Fifty-seven households participated in the study. A total of 212 subjects were measured; a sub-sample of 79 adults was also interviewed. The study identified 17 diabetics (12 females, 5 males). Prevalence of NIDDM for the sampled population was calculated at 8.2 percent. The rate was higher among females than among males. Diabetics were older than 45 years of age, were in poor health, had more than one source of income, and depended on social safety net assistance; high parity was characteristic of diabetic females. Diabetics' blood glucose (B.G.) levels were higher than those of non-diabetics, regardless of the variables tested. Known risk factors for NIDDM were not found to be significantly strong in the determination of diabetic status nor of B.G. levels. However, the ethnographic and quantitative data suggested that physiological variables may be affected by work and occupational related risks, diluting the prediction strength of known NIDDM risk factors. The yearly cycles of farm work and the physiological demands of the tasks involved are probably the most salient risk factors in farmworkers' lives. Recommendations are provided for the incorporation of anthropological theory, methods and techniques to the study of disease processes, and for the design of public health strategies.